Endoluminal treatment method and associated surgical assembly

Abstract

A surgical instrument includes a hollow member having a sidewall provided with a window and a closure member movably connected to the hollow member for alternately covering and uncovering the window. The hollow member has a first clamping surface along an edge of the window, while the closure member has a second clamping surface opposing the first clamping surface and disposable substantially adjacent thereto in a clamping or closure configuration of the instrument. The instrument additionally comprises a tissue occlusion component mounted to at least one of the hollow member and the closure member for acting on tissues gripped between the first clamping surface and the second clamping surface, to couple the tissues to each other.

What is claimed is: 
     
       1. A method of treating tissue comprising:
 inserting into a body of a patient an endoscopic instrument having an expandable chamber in a collapsed configuration, the chamber having a distal portion, a proximal portion and an intermediate portion between the distal and proximal portions; 
 after the insertion of the endoscopic instrument into the patient, expanding the chamber from the collapsed configuration to an expanded configuration to increase a transverse dimension of the chamber at the intermediate portion providing a larger space inside the chamber; 
 inserting a distal portion of a working instrument into the chamber, the working instrument extending through a first channel in the endoscopic instrument, and the distal portion of the working instrument extending laterally with respect to a longitudinal axis of the endoscopic instrument; and 
 visualizing the distal portion of the working instrument by a visualization device which extends through a portion of the endoscopic instrument and is separate and radially spaced from the first channel. 
 
     
     
       2. The method according to  claim 1 , wherein the step of expanding the chamber expands the chamber to only one side of the longitudinal axis of the endoscopic instrument. 
     
     
       3. The method of  claim 1 , wherein the visualization device terminates distally at an opening adjacent the chamber. 
     
     
       4. The method according to  claim 1 , wherein the step of visualizing the distal portion of the working instrument includes the step of angling the visualization device so it extends laterally with respect to the longitudinal axis of the endoscopic instrument. 
     
     
       5. The method according to  claim 1 , further comprising the steps of severing a tissue mass positioned within the chamber and removing the severed tissue mass from the patient by at least one of (i) removing the severed tissue mass via the first channel or (ii) removing the severed tissue mass by retaining the severed tissue mass in the chamber and withdrawing the endoscopic instrument from the patient. 
     
     
       6. The method according to  claim 1 , further comprising the step of receiving a polyp within the chamber and severing the polyp from the body utilizing the working instrument inserted through the first channel of the endoscopic instrument. 
     
     
       7. The method according to  claim 1 , further comprising the step of illuminating at least one portion of the chamber or tissue provided at or protruding into the chamber to enable a visual inspection thereof. 
     
     
       8. A method of treating tissue comprising:
 inserting into a body of a patient an endoscopic instrument having an expandable chamber in a collapsed configuration, the endoscopic instrument further having a stiffening rod positionable proximal of the chamber, the stiffening rod movable with respect to the chamber to assist formation of the chamber; 
 after the insertion of the endoscopic instrument into the patient, expanding the chamber from the collapsed configuration to an expanded configuration to increase a transverse dimension of the chamber providing a larger space inside the chamber; 
 inserting a distal portion of a working instrument into the chamber, the working instrument extending through a first channel in the endoscopic instrument, and the distal portion of the working instrument extending laterally with respect to a longitudinal axis of the endoscopic instrument; and 
 visualizing the distal portion of the working instrument by a visualization device which extends through a portion of the endoscopic instrument and is separate and radially spaced from the first channel. 
 
     
     
       9. The method according to  claim 8 , wherein the chamber has a distal portion, a proximal portion and an intermediate portion between the distal and proximal portions, and the intermediate portion is expandable. 
     
     
       10. The method according to  claim 9 , wherein the step of expanding the chamber expands the chamber to only one side of the longitudinal axis of the endoscopic instrument. 
     
     
       11. The method according to  claim 8 , further comprising the steps of severing a tissue mass positioned within the chamber and removing the severed tissue mass from the patient by at least one of (i) removing the severed tissue mass via the first channel or (ii) removing the severed tissue mass by retaining the severed tissue mass in the chamber and withdrawing the endoscopic instrument from the patient. 
     
     
       12. The method according to  claim 8 , further comprising the step of illuminating at least one portion of the chamber or tissue provided at or protruding into the chamber to enable a visual inspection thereof. 
     
     
       13. A method of endoscopic surgery comprising the steps of:
 providing an endoscopic instrument having a first channel, a separate second channel, a third channel and an expandable chamber at a distal portion of the endoscopic instrument, the first channel radially spaced from the second channel, the third channel having a stiffening member therein to assist formation of the chamber; 
 inserting the endoscopic instrument within a body lumen with the chamber in a collapsed position; 
 expanding the chamber to increase a transverse dimension of the chamber, the expanded chamber expanding laterally relative to the first channel; 
 visualizing the chamber by a visualization device inserted through the second channel, the second channel having an opening to the chamber; and 
 treating tissue within the expanded chamber by a working instrument extending through the first channel, the working instrument having a distal working end extending into the chamber in a lateral direction with respect to a longitudinal axis of the endoscopic instrument. 
 
     
     
       14. The method of  claim 13 , wherein the step of inserting the endoscopic instrument comprises inserting the endoscopic instrument into a colon to remove a polyp, and the polyp is severed and carried within the first channel outside the body lumen. 
     
     
       15. The method according to  claim 13 , wherein the chamber has a distal portion, a proximal portion and an intermediate portion between the distal and proximal portions, and the intermediate portion is expandable. 
     
     
       16. The method of  claim 15 , wherein the stiffening member is positionable proximal of the chamber. 
     
     
       17. The method of  claim 15 , wherein the step of expanding the chamber expands the chamber laterally to only one side of the longitudinal axis of the endoscopic instrument. 
     
     
       18. The method of  claim 15 , wherein the step of expanding the chamber expands the chamber laterally of the stiffening member. 
     
     
       19. The method according to  claim 13 , further comprising the step of illuminating at least one portion of the chamber or tissue provided at or protruding into the chamber to enable a visual inspection thereof.